What is Infertility? How Is It Treated?
Infertility is the inability to conceive despite the fact that couples do not use any birth control method and can maintain normal sexual relations.
There are two types of infertility:
Primary infertility; Inability to conceive without protection for at least one year.
Secondary infertility; It is the inability to become pregnant even though at least one pregnancy event has occurred before.
Causes of Infertility:
These reasons can only be in women (40-50%), only in men (30-40%), or in both (10-20%) couples.
Causes of female infertility:
The egg cells formed during the pregnancy process encounter the male sperm cell on their way from the tubes to the uterus. As a result of fertilization, the embryo placed in the uterus grows and the pregnancy process continues. However, one or more of the following problems may negatively affect this natural process and prevent pregnancy.
Couples under the age of 30 who have a healthy and regular sexual life have a 25-30% chance of getting pregnant every month. The probability of getting pregnant after the age of 35, especially after the age of 40, decreases in women. In addition, the risk of miscarriage increases after the age of 35.
Causes of infertility:
- * Occlusion in the tubes
- * Irregular menstrual cycle
- * Decreased ovarian reserve
- * Past infections or intra-abdominal operations
- * Endometriosis
- * Ovulation problems
- * High prolactin level
- * Polycystic Ovary Syndrome (PCOS)
- * Early menopause
- * Uterine Fibroids
- * Intra-Abdominal Adhesion
- * Thyroid Problems
- * Cancer history and cancer treatment
- * Liver and kidney diseases
- * Diabetes
- * Obesity
- * Excessive smoking and alcohol consumption
Diagnostic Methods in Female Infertility:
Although it can be waited for 1 year for women under the age of 30 to conceive, the waiting period for the possibility of spontaneous conception over the age of 35 is reduced to 6 months. Specific infertility tests can be performed after a general physical and pelvic examination.
- * Ovulation Test: Hormone analysis to detect whether ovulation has occurred
- * Hysterosalpingography (HSG): It is the removal of a medicated uterine film to see if there is obstruction in the uterus and tubes or any other obstructive cause.
- * Ovarian Reserve Test: These are hormonal tests that will show sufficient quality egg development in the ovaries. It is done at the beginning of the period.
- * Other hormone tests: Pituitary hormones, Thyroid hormones, Androgenic hormones.
- * Pelvic ultrasonography and SF Infusion sonogram
- * Hysteroscopy: Evaluation of the uterine cavity and cervix with an illuminated endoscopic system
- * Laparoscopy: Minimally invasive surgical methods include evaluation of the uterus, ovaries and tubes, and investigation of endometriosis and other adhesions that may cause obstruction.
Causes of infertility in men include:
- * Decreased sperm count and motility
- * Structural problems of sperm
- * Absence of any sperm cells in the semen (Azospermia)
- * Channel blockages
- * Sperm not coming out
- * Hormonal causes
- * Undescended testis
- * Diseases such as febrile diseases in childhood, mumps in adolescence
- * Genetic diseases
- * Varicocele
- * Diseases such as syphilis, gonorrhea
- * Sexual dysfunctions (such as erectile dysfunction and premature ejaculation)
- * Diabetes
- * Previous cancer treatment
- * Infections
- * Testosterone deficiency
- * Excessive smoking or alcohol consumption
- * Stress
Male Infertility Diagnostic Methods:
Semen Analysis: It is done after 3-4 days of sexual abstinence. First of all, the amount of seminal fluid, sperm count, motility and structural features are evaluated. Sometimes, urine semen analysis can also be done to evaluate reflux into the bladder.
- * Hormone Test: Testosterone and other male hormones are investigated.
- * Genetic Testing
- * Testicular Biopsy
- * Imaging methods: Transrectal or scrotal ultrasound, vasography, brain MRI
- * Other Special Tests: Investigation of DNA abnormalities in semen fluid
Treatment Approaches in Female Infertility:
- Many women can become pregnant with treatment. However, some may require more complex and long-term treatment applications.
Stimulation of Ovulation: With some infertility drugs, egg development and release are tried to be achieved.
Intrauterine Insemination: In this method, which is known as 'Inoculation' in the society, when the developing egg is released (ovulation), the healthy sperm cell is placed in the uterus to ensure fertilization.
Fertilization Surgery: It is the surgical removal of endometrial polyps, uterine septum, intrauterine adhesions and some fibroids.
Assisted Reproductive Techniques (ART)
In this context, IVF, also known as IVF, is the most frequently applied approach. It is the process of fertilizing a large number of mature egg cells obtained from the woman with sperm in the laboratory environment and placing the formed embryo in the uterus.
Dr. Lecturer Tolga SISLI
Gynecology and Obstetrics Specialist
Adr.: Hancerli Mahallesi. Derviszade Sokak. Simpa Trade Center. No: 12 Kt: 4 Ilkadıim / Samsun
Tel.: +90 543 632 55 00